Adjunctive effect of a water-cooled Nd:YAG laser in the treatment of chronic periodontitis.

OBJECTIVES: To test whether use of a water-cooled Nd:YAG laser adjunctive to supra- and subgingival debridement (SRP) with hand and ultrasonic instruments results in greater clinical improvement than SRP alone. Another objective was to investigate the reduction in the number of microorganisms. METHODS: This study was an examiner-blind, randomized and controlled clinical trial using a split-mouth design. Nineteen subjects with moderate-to-severe generalized periodontitis were selected. Immediately following SRP in two randomly chosen contra-lateral quadrants, all pockets 4 mm were additionally treated with the Nd:YAG laser (1064 nm, 6 W, 400 mJ). Clinical assessments (Plaque index, bleeding on pocket probing, probing pocket depth) were performed pre-treatment and at 3 months post-treatment. In each quadrant, one site was sampled for microbiological evaluation at pre-treatment, immediately post-instrumentation and 3 months post-treatment. RESULTS: At the 3-month visit, the clinical parameters had significantly improved for both regimens. No significant differences between treatment modalities were observed for any of the clinical parameters at any time. Immediately following instrumentation, the total colony forming units for both groups were significantly reduced as compared with pre-instrumentation. No significant differences between treatment modalities were observed. CONCLUSIONS: Three months after SRP, no additional advantage was achieved with the additional use of the Nd:YAG laser. Microbiological findings reflect these clinical results.